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The Same Script: Value-Based Payment, Managed Care, and Neoliberalism
The Same Script: Value-Based Payment, Managed Care, and Neoliberalism

The Same Script: Value-Based Payment, Managed Care, and Neoliberalism

Though heralded as a policy innovation, value-based payment has not succeeded in lowering costs and has instead fueled corporate consolidation, as many physicians are ill-equipped to assume the financial risk that the payment model requires. Embodying the core tenets of neoliberalism, VBP is ultimately a failure of policymakers to equitably and efficiently administer a public health care program.

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Anti-Domination and the Future of Progressive Administration

The Trump administration is simultaneously dismantling, weaponizing, and centralizing state capacities in order to enact a reactionary vision of administration — one which seeks to roll back efforts by prior generations to equalize economic and social relations. In contrast to this vision, progressives ought to aspire to a regulatory state whose purpose is to prevent domination. This alternative vision can guide us in deciding which forms of administrative power we should build and which we should actively work to restrain.

Why Public Ownership?

Calls for public ownership often highlight the downsides of private ownership: how capitalist firms prioritize profit over providing quality services at fair prices. But what, specifically, do we value in its public counterpart? While Sandeep Vaheesan defends public ownership in the power sector primarily on democratic grounds, the left should emphasize its potential to address key obstacles to rapid decarbonization.

On Tariffs and the Ends of International Economic Law

For decades, the rules of international trade helped cement U.S. firms at the top of global value chains. Should Trump’s unapologetic embrace of tariffs be understood as part of a broader loss of faith in those rules among American policymakers? Or is it something else entirely — a bid to remake the relationship between capital and political power within the United States itself?

A Call To Defend Free Speech From Weaponized Allegations of Terrorism Ties

When students, staff, or faculty are accused of being associated or “aligned” with terrorist organizations, universities may be pressed to take immediate and harsh action, if only to quell media attention and appear compliant with this lawless Administration’s wishes. Universities must prepare for this possibility, learn about the underlying legal frameworks, and refuse to operate on the basis of fear rather than legal necessity or moral principle.

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Local Electricity and Bottom-up Energy Planning

To build an electric system that meets the needs and opportunities of the 21st century, we need proposals that strengthen public control and improve regulation of Investor-Owned Utilities. Yet on their own, such proposals ignore a fundamental issue: almost all federal, state, municipal, and coop utilities currently operate with the same centralized, top-down. . .

Weekly Roundup: July 11

Bijal Shah on how the Supreme Court enables Trump’s illegal immigrations actions, Fumika Mizuno on the consolidation of the dialysis market, and Morgan Harper on building the movement that Democrats won’t. Plus, cool new CFPs, jobs, books, and think pieces on your favorite mayoral candidate.

Beyond The Ballot: Building The Movement Democrats Won’t

The MAGA movement has preyed on the economic decay and social malaise plaguing America’s neighborhoods, offering a suite of real and imagined villains to drive Trump’s ascension. The left must get back to basics, rebuilding the trust lost by the Democratic Party through genuine community building and connection across difference.

A Dialysis Duopoly: How Public Funding Entrenched Private Power

For the half-million people in the U.S. with kidney failure, survival rests in the hands of two powerful corporations — DaVita and Fresenius — that control over 70% of the outpatient dialysis market. But the history of dialysis isn’t a simple narrative of corporate consolidation; it’s a case study of how public funding can entrench private power. . .

State Efforts to Rein in Corporate Medicine

Private equity firms are acquiring dominant shares of physician practices, creating conflicts between shareholder value and physicians’ professional and ethical duties. While longstanding state laws that prohibit lay ownership of medical practices have been under-enforced and evaded, recent litigation and legislative proposals suggest they could be. . .